Prostate cancer detection rate in Indonesian men.

ABSTRACT

PURPOSES OF THE STUDY To evaluate the overall detection rate of prostate cancer in biopsies according to serum prostate-specific antigen levels, determine the number of cores biopsied in Indonesian men, and provide a correlated staging of prostate cancer patients at varying intervals of prostate-specific antigen levels. METHODS: We retrospectively analyzed the data from Indonesian men who had undergone prostate biopsy at two national referral medical centers in Jakarta from January 1995 to December 2014. Prostate biopsy was performed when levels of prostate-specific antigen were>4.0 ng/mL or malignancy was suspected upon digital rectal examination. RESULTS: Of 2942 men who underwent biopsies, 844 (28.7%) were diagnosed with prostate cancer. When patients were stratified into five subgroups by serum prostate-specific antigen levels (< 4.0, 4.0-9.9, 10.0-19.9, 20.0-100.0, and>100.0 ng/mL), the overall detection rate of prostate cancer was 21.0%, 9.3%, 13.1%, 35.4%, and 92.9%, respectively. The detection rate was significantly higher in patients who underwent 10-core biopsies than in patients who underwent 6-core biopsies (31.6% vs. 22.4%, p<0.001). The receiver operating characteristic analysis to detect locally advanced/metastatic prostate cancer found that serum prostate-specific antigen levels of 42.7 ng/mL had a sensitivity of 74%, specificity of 73%, positive predictive value of 85.2%, and negative predictive value of 57.5%, with area under the curve of 0.81 (95% confidence interal 0.78 to 0.84). CONCLUSION: The overall detection rate of prostate cancer in Indonesian men was 28.7%. The prostate cancer detection rate appeared to be lower than that observed in white men.